發(fā)布時(shí)間：2018-07-13 12:24

【摘要】：目的了解南京市兒童醫(yī)院重癥肺炎患兒病原學(xué)分布及主要病原菌耐藥性。方法選取2016年01月-12月重癥肺炎患兒198例作為研究對(duì)象,收集患兒鼻咽分泌物行病原菌培養(yǎng)及藥敏鑒定,并采用實(shí)時(shí)熒光定量PCR技術(shù)(qPCR)對(duì)其他病原進(jìn)行檢測(cè)。結(jié)果 198例患兒中有141例檢出至少一種病原體,總檢出陽性率為71.2%;共檢出病原菌115株,占46.37%,其中革蘭陰性菌85株,占34.27%,革蘭陽性菌31株,占12.50%,病原菌中鮑氏不動(dòng)桿菌檢出最多,為21株占8.47%;共檢出病毒86株,占34.68%,鼻病毒檢出最多,為21株占8.47%;非典型病原體46株占18.55%,肺炎支原體31株占12.5%,為檢出最多的病原體;藥物敏感試驗(yàn)提示革蘭陰性菌對(duì)常見的青霉素類及一、二代頭孢均有很高的耐藥率,對(duì)于三、四代頭孢菌素以及碳青霉烯類等藥物也有一定程度的耐藥。結(jié)論南京地區(qū)兒童重癥肺炎病原仍以病原菌為主,革蘭陰性菌占優(yōu)勢(shì),主要病原菌對(duì)多種抗菌藥物耐藥。
[Abstract]:Objective to investigate the pathogenic distribution and drug resistance of major pathogens in children with severe pneumonia in Nanjing Children's Hospital. Methods 198 children with severe pneumonia from January to December 2016 were selected to collect nasopharyngeal secretions for pathogen culture and drug sensitivity identification, and real-time fluorescence quantitative PCR (qPCR) was used to detect other pathogens. Results at least one pathogen was detected in 141 out of 198 cases, the total positive rate was 71.2%, 115 strains (46.37%) were detected, of which 85 strains were Gram-negative bacteria (34.27%), 31 strains were Gram-positive bacteria (12.50%), and the most were Acinetobacter baumannii. There were 86 strains of virus (34.68%), 21 strains of rhinovirus (8.47%), 46 strains of atypical pathogens (18.55%) and 31 strains of mycoplasma pneumoniae (12.5%). The drug sensitivity test indicated that Gram-negative bacteria had high resistance to penicillin and the first and second generation cephalosporins, and to some extent to the third and fourth generation cephalosporins and carbapenes. Conclusion the main pathogens of severe pneumonia in children in Nanjing are mainly pathogenic bacteria, Gram-negative bacteria are dominant, and the main pathogens are resistant to many kinds of antimicrobial agents.
【作者單位】： 揚(yáng)州大學(xué)附屬醫(yī)院兒科;南京醫(yī)科大學(xué)附屬兒童醫(yī)院呼吸科;
【分類號(hào)】：R725.6

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